title: Smoldering multiple myeloma: present position and potential promises.
abstract: Since smoldering multiple myeloma (SMM) was first described over three decades ago based on a case series of six patients, its definition and our understanding of the entity have evolved considerably. The risk of progression to symptomatic myeloma (MM) varies greatly among individuals diagnosed with myeloma precursor disease. Epidemiologic, molecular, flow cytometric and radiological techniques have demonstrated that this transformation to MM from precursor states is not sudden but rather a continuous overlapping series of events with evidence of end-organ damage that could manifest in the earliest stages of disease. Contemporary antimyeloma therapies can yield rapid, deep, and durable responses with manageable toxicities, and molecular-cell-based measures are now available to rule out minimal residual disease. With this information, clinical studies with correlative measures can now be developed to test the fundamental hypothesis that intervention in early myeloma may provide a measurable clinical benefit to patients by either delaying progression or eradicating plasma cell clones.
authors.affiliation: Multiple Myeloma Section, Metabolism Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Nishant
authors.initials: N
authors.lastname: Tageja
authors.forename: Elisabet E
authors.initials: EE
authors.lastname: Manasanch
authors.forename: Neha
authors.initials: N
authors.lastname: Korde
authors.forename: Mary
authors.initials: M
authors.lastname: Kwok
authors.forename: Sham
authors.initials: S
authors.lastname: Mailankody
authors.forename: Manisha
authors.initials: M
authors.lastname: Bhutani
authors.forename: Mark
authors.initials: M
authors.lastname: Roschewski
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
mesh_terms: D001853:Bone Marrow / Q000473:pathology; D001842:Bone and Bones / Q000473:pathology; D003952:Diagnostic Imaging; D018450:Disease Progression; D005434:Flow Cytometry; D006801:Humans; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000175:diagnosis / Q000209:etiology; D009101:Multiple Myeloma / Q000175:diagnosis* / Q000209:etiology; D011230:Precancerous Conditions; D012307:Risk Factors
keywords: carfilzomib; flow cytometry; lenalidomide; multiple myeloma; plasma cell dyscrasia; smoldering myeloma